Hunt challenges the NHS to deliver digital services by 2018

The Health Secretary, Jeremy Hunt, has challenged the NHS to deliver digital services nationwide by 2018 to coincide with the NHS’ 70th anniversary next year.

Hunt used September’s Health and Care Innovation Expo in Manchester to highlight the opportunity of technology in creating ‘The patient power decade’. The Health Secretary painted a pixelated portrait of a future shift in power within the NHS from doctor to patient, with the patient ‘Using technology to put themselves in the driving seat of their own healthcare destiny.’

Hunt stated that by the end of 2018, patients will be able to use an integrated smartphone app to access services such as NHS 111, book a GP appointment and even have the ability to view healthcare records online.

Currently, according to NHS Digital, 680,000 patients are viewing their medical records online every month.

In this keynote speech, he further acknowledged how ‘People should be able to access their own medical records 24/7, show their full medical history to anyone they choose and book basic services like GP appointments or repeat prescriptions online.’

Mr Hunt also stated that the app could be used to order repeat prescriptions, access support for managing long-term conditions, or express preferences on organ donation, data sharing, and end-of-life.

Hunt emphasised how the ‘master-servant relationship’ between doctors and patients that has existed for three millennia will be ‘turned on its head’, and patients will use the information that becomes available at their fingertips, ‘to exert real control in a way that will transform the prospects of everyone.’

Overcoming hurdles

If the NHS is to successfully deliver digital health services, there are a number of potential hurdles to overcome. Firstly, there are concerns over the accessibility of services for those unfamiliar with smartphone technology, or from those of disadvantaged backgrounds who cannot afford to buy a smartphone. For this reason, Hunt stressed how the new services will be for everyone:

‘If the NHS is not there for everyone, it is nothing,’ he said. ‘We recognise that not everyone is comfortable using a smartphone. So we will always make sure that when we introduce new services, there is a face-to-face or telephone alternative, for people who do not use smartphones.’

While many older people struggle with online technology, it is worth pointing out this is not always for want of trying. Hunt outlined how 400 000 people have already been trained to help get them online, and over the next 3 years, a further 20 000 digital inclusion hubs will be rolled out. Additionally, wifi will be introduced across primary care this year and secondary care next year, which is hoped will help support people accessing online resources.

Secondly, in lieu of the NHS cyber attacks earlier this year, Hunt conceded that a lot needs to be done to win back the public’s trust:

‘We have to recognise that we still have a lot to do to earn the public’s trust that their patient data is safe with us,’ he said.

As part of this, the Government announced its response to the National Data Guardian and Care Quality Commission report on data security in July. Among the initiatives are 10 new data security standards, a £21 million investment to protect trauma centres from cyber attack and new national support for unsupported Microsoft systems that were part of the original problem that caused the cyber attacks.

The role of mobile technology in delivering health services was also highlighted in a keynote speech from Professor Sir Bruce Keogh, medical director of the NHS. He said we run our social lives, financial lives, travel lives and retail lives online, so why not our health? Keogh welcomed the idea of being able to book GP appointments, get blood results or see X-rays online. However, he also recognised that it brings with it some challenges.

The first challenge is digital therapy, particularly in the area of mental health. According to Keogh, this will involve activities patients can do on their mobile phone that will improve their health, such as talking therapies, so that they do not have to visit a psychologist, psychiatrist or your GP. The NHS will have to work out how it assesses these, but importantly it needs to work out the payment mechanisms behind them so that they are available for everyone on the NHS.

The second challenge concerns what happens when people can get advice and treatment outside normal geographical boundaries. Currently, the way the NHS is structured means a GP is determined by where a patient lives. However, Keogh highlighted how already many are visiting GPs outside the area where they live. He therefore questioned what happens as more people start to access health care not just beyond their local area but beyond their regional area and possibly internationally. He stressed the need to work out who pays for what, the duties of Government and arm’s length bodies with respect to ensuring the safety of those transactions, and the legal implications. The issue is how this can be made part of the NHS, rather than creating a two-tier ‘pay for it if you can’ service.

Looking to the future

Pilot schemes are already underway, with ongoing evaluation before the digital service is introduced nationally. According to Hunt, initial results from pilots in north London, Leeds, London and Suffolk, show that when NHS 111 services are transferred online it is safe. He also pointed out that if digital health services are introduced in the right way, it will save the NHS money. He said: ‘The 6% of people who use the 111 app, rather than speaking to the call handler, save the NHS money. That’s more resources for doctors and nurse.’

Looking to the future, Hunt confirmed that the Government are trying to build the safest, highest quality health system in the world. The role of technology, therefore, is one that he believes is of the utmost importance in making this a reality:

‘As we grapple with the challenges of resources, challenges to improve patient safety, challenges to improve quality and challenges to improve changing consumer expectation, technology can be our friend if we recognise it as a means to an end and not an end in itself, and that end is safer, healthier patients,’ he said.

Taken from British Journal of Healthcare Management, published October 2017.